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. CITY OF ORONO * Z 0 1 6 - 0 0 4 4 7 * <br /> 2750 KELLEY PARKWAY DATE ISSUED: 04/27/2016 <br /> ORONO, MN 55356- <br /> (952) 249-4600 FAX: (952) 249-4616 <br /> ADDRESS : 960 FERNDALE RD W <br /> PIIv : 02-117-23-44-0017 <br /> LEGAL DESC : COUNTRY CLUB ESTATES <br /> : LOT 000 BLOCK 000 <br /> PERMIT TYPE : MECHAN[CAL <br /> PROPERTY TYPE : RESIDENTIAL <br /> CONSTRUCTION TYPE : HEATING SYSTEMS <br /> VALUAT[ON : $ 2,842.00 <br /> NOTE: (1)LENNOX FURANCE-4"FLUE,60,000[NPUT BTU'S,48,000 OUTPUT BTU'S,830 CFM <br /> APPLICANT MECHANICAL 50.00 <br /> STATE SURCHARGE MECH(VALUATION) 1.42 <br /> DITTER COOLING&HEATING TOTAL 51.42 <br /> 820 TOWER DRIVE Payment(s) <br /> MEDINA,MN 55340 CREDIT CARD 7511 51.42 <br /> (763)478-9558 <br /> Minnesota State License#:mech-MB003161 <br /> OWNER <br /> BROOKS,JOHN&JOAN <br /> 960 FERNDALE RD W <br /> WAYZATA,MN 55391- <br /> AGREEMENT AND SWORN STATEMENT <br /> The work for which this permit is issued shall be performed according to <br /> the approved plans and specifications,applicable City approvals,and the <br /> State Building Code. This permit is for only the work described and does <br /> not grant permission for additional or related work which requires separate <br /> permits. All provisions of laws and ordinances goveming this type of work <br /> shall be compied with whether or not specified herein.This permit will <br /> expire and become null and void if construction authorized is not <br /> commenced within 180 days of the date of issuance,or if construction is <br /> suspended for a period of]80 days at any time after work has commenced. <br /> The applicant is responsible for assuring all required inspections are <br /> requested in conformance with the Sta[e Building Code.This permit may be <br /> revoked at any time for due cause. <br /> _ � � ^�� �� � 'G �� �/ <br /> Applicant Pe itee Signature Date [ssu y Signature Date <br />